Go Beyond Raw Data
When an audit process involves our Compliance Risk Analyzer, you’re doing more than just gathering raw data — you’re giving your organization an efficiency boost that lets you allocate resources toward audit preparation without having to spend massive amounts of valuable time identifying potential risk areas. CRA replaces the need to interpret raw claims data with a unique scoring system. Advanced calculations and comparisons are distilled into an easy-to-understand risk score from 0 to 100, representing how high or low a provider’s audit risk is. Users are then presented with an automated Audit Action Plan for every provider – prioritized by provider and code – to quickly determine where internal reviews are required.
A Straightforward System
Internal Auditors shouldn’t need to have advanced degrees in statistics to create meaningful change in your organization. CRA distinguishes itself by its ability to condense overwhelming reams of data into actionable targets. Reports are organized in a similar pattern, making it easy for any team member to assess risk and correct situations that are causing that risk.
Risk Management and Revenue Enhancement
By analyzing claims on a regular basis, you shield your organization and providers from the hardships of an audit and even flip the switch on payers. CRA’s laser-like precision isn’t just able to identify audit risks, it also finds opportunities where claims may have left money on the table. Our clients have successfully realized significantly higher payments going forward after reviewing the under-coded claims flagged by CRA – and you can too.
Building our Clients’ Reputations
“Their accessibility is unmatched; they make themselves available for quick calls as well as for in-depth discussions about the CRA reports. Furthermore, they routinely incorporate feedback from users to enhance CRA.”
Director, Systems Ethics & Compliance
An Ohio Healthcare Systems | 35K Providers
“The predictive analytics that are available with the Compliance Risk Analyzer (CRA) program mimic some of the same data mining techniques our payers are using today to locate risk and potential audit opportunities. This program has given us the opportunity to really zone in on our risk areas and audit providers that are flagged as high-risk along with the codes that are identified.”
Compliance Senior Analyst
A Michigan Healthcare System | 4.5K Providers
“We had several providers selected for a TPE audit. Using CRA, we were able to confirm that these providers were the top utilizers of the code; it contributed significantly to their risk score and was on their audit plan. Using CRA will now allow us to be proactive so we can respond to these audits with confidence.”